东非的围产死亡率:一个系统的审查和元分析
Yohanis Alemeshet Asefa1,2, Assefa Tola Gemeda3, Hannah Blencowe4
1Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK.
概括
东非的围产死亡率很高,感染和产后事件是主要原因. 解决可修改的风险因素和改善护理质量可以预防许多死亡.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 孕产妇和儿童的健康
背景情况:
- 在全球范围内,死产和新生儿死亡率很高,特别是在撒哈拉以南非洲和南亚.
- 现有的数据可能低估了围产期死亡率的真正负担.
- 新生儿死亡和死胎的具体原因在主要类别之外仍然不明.
研究的目的:
- 系统地审查和对东非围产儿死亡率的证据进行元分析.
- 确定该地区围产死亡率的发病率,原因和风险因素.
- 为公共卫生政策和减少围产死亡的干预措施提供信息.
主要方法:
- 进行全面的数据库搜索 (Medline,科学网,EMBASE等) 没有语言限制.
- 包括在2010-2022年期间发表的观察性研究和社区试验.
- 对汇总死亡率的随机效应元分析和风险因素的叙事综合.
主要成果:
- 聚合人口的围产期死亡率为33.1/1000例出生,在卫生设施中的死亡率为67.1/1000例.
- 感染和产后相关事件是主要原因,尽管详细数据有限.
- 关键的风险因素包括低社会经济地位,缺乏产前护理和孕产妇的并发病;妇女赋权和产妇等待中心是保护性的.
结论:
- 产前死亡率仍然是东非的重大公共卫生挑战.
- 通过解决可修改的风险因素和加强产前和产后护理,可以减少可预防的死亡.
- 标准化死亡原因分类和提高数据质量对于有针对性的干预至关重要.
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